DR. OLLIE JOSEPH JACKSON III M.D.
NPI 1104084698
Surgery in Beverly Hills, CA

Q: What is Ollie Jackson's NPI number?

The NPI number for Ollie Jackson is 1104084698. It was assigned to this individual provider in the NPPES registry on May 30, 2008. The provider is also known as Dr. Jay Jackson M.D..

Q: What is Ollie Jackson's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Ollie Jackson was last updated on March 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 30, 2008PECOS EnrolledAccepts Medicare Assignment

9001 WILSHIRE BLVD, SUITE #106, BEVERLY HILLS, CA 90211(310) 273-8885(310) 273-8662 Get Directions Write a Review

NPPES record last updated: March 15, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Ollie Joseph Jackson Iii M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. OLLIE JOSEPH JACKSON III M.D. (NPI 1104084698) is an individual surgery provider in Beverly Hills, California, licensed in California (A103543) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS and is a graduate of University Of Oklahoma College Of Medicine (2001).

NPPES Registry Identity

NPI1104084698

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameDR. OLLIE JOSEPH JACKSON IIICredential: M.D.

Location Address9001 WILSHIRE BLVD, SUITE #106Beverly Hills, CA 90211-1838

Mailing Address9001 Wilshire Blvd, Suite #106Beverly Hills, CA 90211-1838 · (310) 273-8885 · Fax (310) 273-8662

Phone(310) 273-8885

Fax(310) 273-8662

Sole ProprietorYes

Medical School CMSUniversity Of Oklahoma College Of MedicineGraduated 2001

Enumeration DateMay 30, 2008

Last NPPES UpdateMarch 15, 2023

NPPES CertifiedMarch 15, 2023

✔ NPI 1104084698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in CA · A103543

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Also ListedSurgery · Plastic and Reconstructive SurgeryTaxonomy 2086S0122X · License A103543 (CA)

9001 WILSHIRE BLVD, Beverly Hills, CA 90211

Open in Google Maps ↗

Other Names 1

Other Name (5)Dr. Jay Jackson M.d.

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Ollie Joseph Jackson Iii M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3476707043

PECOS Enrollment IDI20230501002893

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Ollie Jackson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Izuchukwu Okpara MD Inc

28 mi

Surgery

28212 KELLY JOHNSON PKWY STE 200
Valencia, CA 91355

Reassigned Medicare billing, California enrollment
51 clinicians in this Medicare group

NPI 1679004592 (213) 228-3538

Wound Docs Apc

51 mi

Surgery

27141 ALISO CREEK RD STE 235
Aliso Viejo, CA 92656

Reassigned Medicare billing, California enrollment
23 clinicians in this Medicare group

NPI 1629891676 (562) 800-3321

Crescent Wound Care Inc

289 mi

Internal Medicine

1310 W GRANGER AVE
Modesto, CA 95350

Reassigned Medicare billing, California enrollment
46 clinicians in this Medicare group

NPI 1841920501 (858) 936-7307

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90211 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ULTRASOUND SPECIALISTS LLC

Clinic/Center (Multi-Specialty)

9001 WILSHIRE BLVD, SUITE 106
BEVERLY HILLS, CA 90211

Los Angeles County (310) 273-8885

OAKHURST SURGICAL CENTER, LLC

Clinic/Center (Ambulatory Surgical)

9001 WILSHIRE BLVD, SUITE 106
BEVERLY HILLS, CA 90211

Los Angeles County (310) 273-8094

MOSES J FALLAS M.D.

Surgery

9001 WILSHIRE BLVD, SUITE 304
BEVERLY HILLS, CA 90211

Los Angeles County (310) 855-1023

INDEPENDENT MEDICAL SERVICES, INC., A PROFESSIONAL CORPORATION

Surgery

9001 WILSHIRE BLVD, SUITE 105
BEVERLY HILLS, CA 90211

Los Angeles County (310) 230-5741

LAPBAND SPECIALISTS LLC

Clinic/Center (Multi-Specialty)

9001 WILSHIRE BLVD, SUITE 106
BEVERLY HILLS, CA 90211

Los Angeles County (310) 273-8885

ANESTHESIA SPECIALISTS LLC

Clinic/Center (Multi-Specialty)

9001 WILSHIRE BLVD, SUITE 106
BEVERLY HILLS, CA 90211

Los Angeles County (310) 273-8885

KNT PHYSICAL THERAPY INC.

Physical Therapist

9001 WILSHIRE BLVD, 102
BEVERLY HILLS, CA 90211

Los Angeles County (310) 550-8585

DR. ELI GINSBURG M.D.

Legal Medicine

9001 WILSHIRE BLVD, 302
BEVERLY HILLS, CA 90211

Los Angeles County (310) 276-9588

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ollie Jackson's NPI number?

The NPI number for Ollie Jackson is 1104084698. It was assigned to this individual provider in the NPPES registry on May 30, 2008. The provider is also known as Dr. Jay Jackson M.D..

Where is Ollie Jackson located?

Ollie Jackson practices at 9001 Wilshire Blvd Suite #106, Beverly Hills, CA 90211. The listed phone number is (310) 273-8885.

What is Ollie Jackson's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Ollie Jackson enrolled in Medicare?

Yes. Ollie Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Ollie Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ollie Jackson reassigns Medicare benefits to 3 organizations: Izuchukwu Okpara MD Inc (Valencia, CA), Wound Docs Apc (Aliso Viejo, CA) and Crescent Wound Care Inc (Modesto, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ollie Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ollie Jackson accept?

Health plans from CareSource (Common Ground Healthcare) list Ollie Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ollie Jackson was last updated on March 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.